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New York rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $5.15 / $20.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $1.65 / $4.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $1.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.62 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $1.13
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.45
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.45
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.88 / $2.79
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.56 / $12.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.78
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.45 / $0.95